OBJECTIVES: To examine the effects of drug treatment on overactive bladder (OAB) symptom improvement and resource utilization. METHODS: We conducted an observational study of 217 OAB patients enrolled by 31 physicians nationwide. One hundred twenty-two patients have been tracked through 3 months to determine symptom improvement, change(s) in treatment, and resource utilization. The impact of medication on OAB symptom improvement was modeled using stepwise logistic regression adjusting for patient age, sex, symptom duration, symptom severity, incontinence, frequency of leakage accidents, and frequency of urinations. RESULTS: Participants averaged 60.7 years old (S.D.=15.7), 85.2% were female, and the mean duration of OAB symptoms was 8.1 years. On average, patients experienced 11.0 urinations per day (S.D.=4.7) and 2.2 accidents per day (S.D.=3.4). Treatment with medication increased the odds of symptom improvement by four-fold (odds ratio (O.R.)=4.3, 95% confidence interval (CI) 1.8-9.9). Patients with incontinence were significantly more likely to report improvement in symptoms compared with patients with urinary frequency alone (O.R.=3.2, 95%CI 1.2-8.4). Nineteen of 72 (26%) patients not started on medication at baseline began medication within the first 3 months, consuming an average of 1.16 office visits per patient. In contrast, 11 of 50 patients (22%) who were started on medication at baseline discontinued within the first 3 months, consuming an average of 0.64 office visits per patient. Patients staying on medication (39/50, 78%) consumed on average the fewest office visits per patient (0.15), while patients who managed symptoms without medication (53/72, 73%) consumed an average of 0.26 office visits. CONCLUSIONS: Pharmacotherapy significantly improves OAB symptoms and is associated with less office visit utilization. Thus, initiating patients on medication, rather than trying a step-wise care approach, may be a cost-effective means to manage symptoms of OAB.